Pulmonologists’ Opinion on the Use of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease Patients in Spain: A Cross-Sectional Survey

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dc.contributor.authorMiravitlles Fernández, Marc
dc.contributor.authorGonzález-Torralba, Fernando
dc.contributor.authorRepresas-Represas, Cristina
dc.contributor.authorPomares, Xavier
dc.contributor.authorMárquez-Martín, Eduardo
dc.contributor.authorGonzález, Cruz
dc.contributor.authorAmado, Carlos Antonio
dc.contributor.authorForné Izquierdo, Carles
dc.contributor.authorAlonso, Soledad
dc.contributor.authorAlcázar-Navarrete, Bernardino
dc.contributor.authorBarrecheguren, Miriam
dc.contributor.authorJurado Mirete, Juan María
dc.contributor.authorNaval, Elsa
dc.date.accessioned2022-12-18T13:21:09Z
dc.date.available2022-12-18T13:21:09Z
dc.date.issued2022
dc.description.abstractIntroduction: Identifying the variables that guide decision-making in relation to the use of inhaled corticosteroids (ICS) can contribute to the appropriate use of these drugs. The objective of this study was to identify the clinical variables that physicians consider most relevant for prescribing or withdrawing ICS in COPD. Methods: A cross-sectional survey was conducted in Spain from November 2020 to May 2021. Therapeutic decisions on the use of ICS in 11 hypothetical COPD patient profiles were collected using an online survey answered by specialists with experience in the management of patients with COPD. Mixed-effects logistic regression was used to analyze the impact of patients’ characteristics in the therapeutic decision for prescribing ICS or proceeding to its withdrawal. Results: A total of 74 pulmonologists agreed to collaborate in the survey and answered the questionnaire. The results showed great variability, with only 2 profiles achieving consensus for starting or withdrawing the treatment. The frequency and severity of exacerbations influenced the decision to prescribe ICS in a dose-response fashion (1 exacerbation odds ratio (OR) = 1.86, 95% confidence interval (CI) 1.02 to 3.43, two exacerbations OR = 11.6, 95% CI: 4.47 to 30.2 and three OR = 123, 95% CI: 25 to 601). Similarly, increasing blood eosinophils and history of asthma were associated with ICS use. On the other hand, pneumonia reduced the probability of initiating treatment with ICS (OR = 0.54 [0.29 to 0.98]). Lung function and dyspnea degree did not influence the clinician’s therapeutic decision. The results for withdrawal of ICS were similar but in the opposite direction. Conclusion: In accordance with guidelines, exacerbations, blood eosinophils and history of asthma or pneumonia are the factors considered by pulmonologist for the indication or withdrawal of ICS. However, the agreement in prescription or withdrawal of ICS when confronted with hypothetical cases is very low, suggesting a great variability in clinical practice.ca_ES
dc.identifier.doihttps://doi.org/10.2147/COPD.S369118
dc.identifier.issn1178-2005
dc.identifier.urihttp://hdl.handle.net/10459.1/84890
dc.language.isoengca_ES
dc.publisherDove Pressca_ES
dc.publisherTaylor and Francis Groupca_ES
dc.relation.isformatofReproducció del document publicat a https://doi.org/10.2147/COPD.S369118ca_ES
dc.relation.ispartofInternational Journal of Chronic Obstructive Pulmonary Disease, 2022, vol. 27, p. 1577–1587ca_ES
dc.rightscc-by-nc (c) Marc Miravitlles et. al., 2022ca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectCOPDca_ES
dc.subjectExacerbationca_ES
dc.subjectBronchodilatorsca_ES
dc.subjectInhaled corticosteroidsca_ES
dc.subjectEosinophilsca_ES
dc.subjectWithdrawalca_ES
dc.titlePulmonologists’ Opinion on the Use of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease Patients in Spain: A Cross-Sectional Surveyca_ES
dc.typeinfo:eu-repo/semantics/articleca_ES
dc.type.versioninfo:eu-repo/semantics/publishedVersionca_ES
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